HospiMedica international June 2024

A groundbreaking artificial intelligence (AI) tool can predict a patient’s health trajectory by forecasting future disorders, symptoms, medications, and procedures, thereby aiding in clinical decision-making and improving healthcare.

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Sonic Lumen Tomography Offers Breakthrough in Measurement of Peripheral Blood Vessels

he current standard of care of using angiographic information is often inadequate for accurately assessing vessel size in the estimated 20 million people in the U.S. who suffer from peripheral vascular disease. The use of intravascular imaging has proven to enhance the preciCont’d on page 6

oft tissue recovery and regrowth largely depend on the formation of new blood vessels to deliver oxygen and nutrients. However, this process, known as vascularization, can be slow,

and regrowth

like cancer. Clinicians typically use bulk hydrogel scaffolds — crosslinked polymer networks — to aid blood vessel formation during reconstructive surgery, but these scaffolds have limitations. They can cause delays leading to complications like seroma (fluid

Reducing False Positives in Breast Cancer Screening

adiologists typically detect one case of cancer for every 200 mammograms reviewed. However, these evaluations often result in false positives, leading to unnecessary patient recalls for additional testing, which not only causes patient anxiety but also consumes valuable medical resources. Now, a new study has shown how artificial intelligence (AI) can improve the accuracy of breast cancer screening by min-

AI Tool Can Predict Patient Trajectory to Improve Clinical Decision-Making

In a new study, researchers have demonstrated the potential of a new artificial intelligence (AI) tool in predicting a patient’s health trajectory by forecasting future disorders, symptoms, medications, and procedures. This innovative tool could be used to aid clinical decision-making, healthcare monitoring, and improving the efficiency of clinical trials.

The tool – called Foresight – was developed by a team of researchers that included investigators from King’s College London (London, UK; www.kcl.ac.uk) and trained on data from extensive NHS electronic health records (EHRs). Foresight uses a deep learning approach to recognize complex patterns within the vast data of EHRs, both structured and unstructured, for generating predictive insights. The team utilized data from more than 811,000 patients for training three distinct Foresight models and extracted and processed the unstructured (free-text) and structured data (age, ethnicity, and sex) within the EHRs.

The team validated its predictive accuracy by comparing how well its predictions matched the actual health outcomes noted in a smaller data subset. When forecasting the next 10 possible disorders that could appear

next in a patient timeline, Foresight correctly identified the next disorder 68% and 76% of the time in two UK NHS Trusts and 88% of the time in the US MIMIC-III dataset. Similarly, when forecasting the next new biomedical concept which could be a disorder, symptom, relapse, or medication, Foresight achieved a precision of 80%, 81%, and 91%, respectively.

Clinicians also evaluated Foresight's accuracy by creating mock patient timelines with various medical scenarios. When a unanimous agreement on a predicted medical event was reached among the clinicians, Foresight's predictions were found to be 93% relevant from a clinical standpoint. This showcases Foresight's capability for practical applications in risk forecasting, clinical research emulation, disorder progression studies, intervention simulations, and educational purposes.

“Our study shows that Foresight can achieve high levels of precision in predicting health trajectories of patients, demonstrating it could be a valuable tool to aid decision making and inform clinical research,” said Zeljko Kraljevic, Research Fellow in Health Informatics at King's College London. “The proposed purpose of Foresight is not to enable patients to self-diagnose or predict their future, but it could potentially be used as an aid by clinicians to make sure a diagnosis is not missed or for continual patient monitoring for real-time risk prediction. One of the main advantages of Foresight that it can easily scale to more patients, hospital or disorders with minimal or no modifications, and the more data it receives the better it gets.” The study was published in the April 2024 issue of The Lancet Digital Health.

Image: The AI tool predicts the health trajectory of patients by forecasting future disorders, symptoms, medications and procedures

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New AI Method Captures Uncertainty in Medical Images

n the field of biomedicine, segmentation is the process of annotating pixels from an important structure in medical images, such as organs or cells. Artificial Intelligence (AI) models are utilized to aid clinicians by highlighting pixels indicative of diseases or abnormalities. However, these AI models often provide a singular answer, despite the inherent ambiguity in medical image segmentation. For example, five different expert annotators might produce five varied segmentations of a lung nodule in a CT scan, each differing in the existence or extent of the borders of a nodule in a lung CT image. Recognizing these discrepancies and the inherent uncertainties can significantly influence clinical decision-making.

Now, researchers at MIT (Cambridge, MA, USA; www.web.mit.ed) have developed a new AI tool, named Tyche, which is designed to capture the uncertainty in a medical image. Tyche generates multiple plausible segmentations highlighting slightly different areas of a medical image. Users can set the number of output options Tyche provides and choose the most suitable one for their specific needs. One of the key advantages of Tyche is that it does not require retraining for each new segmentation task, making it more user-friendly for clinicians and biomedical researchers than some other AI methods. This tool can be used straight out of the box for various applications, ranging from detecting lesions in lung X-rays to identifying anomalies in brain MRIs, potentially enhancing diagnostic processes or supporting biomedical research by highlighting critical details that might be overlooked by other tools.

In tests using datasets of annotated medical images, Tyche demonstrated its ability to capture the diversity of human annotators effectively. Its best predictions were found to surpass those of baseline models, and it also operated faster. Tyche even outperformed more complex models trained with extensive, specialized datasets. Looking forward, the researchers intend to explore the use of more adaptable context sets, which could include textual descriptions or multiple image types. They are also interested in improving the accuracy of Tyche’s less accurate predictions and refining the system to better recommend the most reliable segmentation options.

“Ambiguity has been understudied. If your model completely misses a nodule that three experts say is there and two experts say is not, that is probably something you should pay attention to,” said senior author Adrian Dalca.

“If you want to take ambiguity into account, you often have to use an extremely complicated model. With the method we propose, our goal is to make it easy to use with a relatively small model so that it can make predictions quickly,” added Marianne Rakic, an MIT computer science Ph.D. candidate.

Sensor Detects Errors in MRI Scans Using Laser Light and Gas

MRI scanners are daily tools for doctors and healthcare professionals, providing unparalleled 3D imaging of the brain, vital organs, and soft tissues, far surpassing other imaging technologies in quality. Despite their critical role in healthcare, these machines are not without faults. The strong magnetic fields within MRI scanners are prone to fluctuations, causing scan errors and disturbances that necessitate regular calibration. This necessity limits the use of advanced scanning methods, such as spiral sequences, which could significantly reduce the time required for diagnosing conditions like blood clots, sclerosis, and tumors. Spiral sequences could also advance MRI research, particularly in studying brain diseases, but the instability of the magnetic field currently makes such scans unfeasible.

Theoretically, these issues could be addressed by a sensor that monitors and maps magnetic field changes, allowing for computer corrections of the imaging errors. However, practically implementing this has been challenging, as traditional sensors that could perform this task disrupt the magnetic field due to their electrical nature and metal components. A breakthrough

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New PET Biomarker Predicts Success of Immune Checkpoint Blockade Therapy

I

mmunotherapies, such as immune checkpoint blockade (ICB), have shown promising clinical results in treating melanoma, non-small cell lung cancer, and other tumor types. However, the effectiveness of these therapies varies significantly, with objective response rates ranging from five to 60% among patients. There is a pressing need for reliable methods to assess responses and determine which patients are likely to benefit from immunotherapy. Traditional approaches for monitoring solid tumor responses, which rely on CT and MRI scans, often lead to significant delays in measuring the effects of treatment. In contrast, molecular imaging techniques, particularly PET, offer a dynamic and non-invasive way to evaluate biomarkers in vivo, providing a promising method for predicting the effectiveness of immunotherapy in real time.

Now, researchers at Peking University (Beijing, China; pku.edu.cn) have identified the protein galectin-1 (Gal-1) as a new PET imaging biomarker for ICB therapy, enabling doctors to predict tumor responses before treatment begins. Utilizing Gal-1 PET imaging can also help in patient stratification and the optimization of immunotherapy treatments, potentially enhancing patient outcomes. In their study, the team used a mouse model to search for novel imaging biomarkers that could indicate how tumors respond to ICB therapy. Proteomic analysis revealed that tumors with low Gal-1 expression were more likely to respond favorably to ICB therapy.

The researchers then proceeded to label Gal-1 with 124I to create a radiotracer (124I-α-Gal-1) and conducted small animal PET imaging and biodistribution studies to verify the tracer’s specificity. PET imaging with 124I-αGal-1 effectively indicated the immunosuppressive status of the tumor microenvironment, allowing for the early prediction of ICB resistance. For tumors predicted not to respond well to ICB, the researchers devised a rescue strategy using a Gal-1 inhibitor, which significantly enhanced the likelihood of successful treatment.

“Gal-1 PET opens avenues for the early prediction of ICB efficacy before treatment initiation and facilitates the precision design of combinational regimes,” said Zhaofei Liu, PhD, Boya Distinguished Professor at Peking University. “This sensitive approach has the potential to achieve individualized precision treatment for patients in the future.” The research was published in the May issue of The Journal of Nuclear Medicine.

Image: Researchers have identified a new imaging biomarker for tumor responses to ICB therapy (Photo courtesy of 123RF)

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Reducing False Positives in Breast Cancer Screening

imizing these false positives without missing true positives.

The study by researchers at Washington University School of Medicine in St. Louis (St. Louis, MO, USA; www.medicine.wustl. edu) and Whiterabbit.ai (Santa Clara, CA, USA; www.whiterabbit.ai) builds on their previous collaboration for the development of an AI algorithm to help radiologists assess breast density on mammograms for identifying people who stand to benefit from additional or alternative screening. That algorithm is marketed by Whiterabbit.ai as WRDensity after receiving clearance from the Food and Drug Administration (FDA) in 2020.

In the current study, the team developed an algorithm to identify normal mammograms with extremely high sensitivity. They went on to run a simulation on patient data to see what would have happened if all of the very low-risk mammograms were taken off the radiologists’ plates, allowing the doctors to

focus on the more questionable scans. The results of this simulation indicated that such an approach would reduce the number of unnecessary patient callbacks for additional testing, yet maintain the same rate of cancer detection.

“At the end of the day, we believe in a world where the doctor is the superhero who finds cancer and helps patients navigate their journey ahead,” said Jason Su, co-founder and chief technology officer at Whiterabbit.ai. “The way AI systems can help is by being in a supporting role. By accurately assessing the negatives, it can help remove the hay from the haystack so doctors can find the needle more easily. This study demonstrates that AI can potentially be highly accurate in identi-

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Image: AI-assisted breast-cancer screening may reduce unnecessary testing (Photo courtesy of Debbie Bennett, WUSTL)

fying negative exams. More importantly, the results showed that automating the detection of negatives may also lead to a tremendous benefit in the reduction of false positives without changing the cancer detection rate.”

Sonic Lumen Tomography Offers Breakthrough in Measurement of Peripheral Blood Vessels

sion of vessel sizing, which in turn has been shown to improve clinical outcomes. Now, a groundbreaking technology offers precise, automatic measurement of peripheral blood vessels to optimize treatment strategies for who suffer from peripheral vascular disease.

Provisio Medical’s (San Diego, CA, USA; provisiomedical.com) Provisio SLT IVUS System uses Sonic Lumen Tomography (SLT) technology to address a critical unmet need for vascular specialists by offering automatic, real-time, precise numeric measurements of the flow lumen of blood vessels, eliminating the need for complex image interpretation. The Provisio Medical's catheter is the first in the world to combine intravascular imaging

and support for crossing catheters, allowing for simultaneous vessel lumen measurement and visualization along with guidewire support and the delivery of radiopaque contrast agents. This integration streamlines the process of gathering and displaying vessel sizing data into a regular clinical workflow, potentially reducing the time needed for data acquisition, the use of contrast media, and exposure to radiation.

The Provisio SLT IVUS System comprises the SLT IVUS P1 System and the SLT IVUS Support Crossing Catheter. This over-thewire intravascular ultrasound catheter features an ultrasound transducer array at its distal end and also functions as a support crossing catheter. Utilizing ultrasound signals similar to sonar technology, the system pro-

vides real-time measurements and visualizations of the peripheral vessel’s flow lumen. Provisio Medical has obtained FDA 510(k) clearance for its Provisio SLT IVUS System. "Clinical outcomes in peripheral vascular disease have consistently been shown to benefit from accurate intravascular measurements, yet adoption has been limited by the additional procedure time and training required to interpret images," said S. Eric Ryan, MD, Chief Executive Officer. "Thanks to the easeof-use of SLT IVUS, which can be incorporated more efficiently in the peripheral vascular workflow, we believe there is the possibility of increased adoption and therefore improved outcomes for many more patients with potentially devastating peripheral vascular disease."

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PET Scans Reveal Hidden Inflammation in Multiple Sclerosis Patients

Akey challenge for clinicians treating patients with multiple sclerosis (MS) is that after a certain amount of time, they continue to worsen even though their MRIs show no change. A new study has now revealed that advanced brain imaging can detect hidden inflammation in MS patients which traditional MRIs fail to pick up, potentially leading to improved treatment strategies.

Researchers from Brigham and Women’s Hospital (Boston, MA, USA; www.brighamandwomens.org) have discovered that positron emission tomography (PET) brain scans can identify hidden inflammation in patients undergoing treatment with highly effective MS therapies. This finding emerged when the research team noted that patients on the most effective MS treatments still experienced symptom progression. Over the past eight years, they have developed a technique to image microglia, immune cells in the brain involved in MS progression, which are not visible on routine MRIs. They utilized 18F-PBR 06 PET imaging, which uses a tracer binding to microglia cells, revealing that increased microglial activity is associated with greater atrophy of gray matter in the brain, impacting cognition, movement, and fine motor skills.

The researchers have coined the term “smoldering” inflammation, comparing it to a smoldering fire that burns slowly without emitting any smoke or flame but continues to cause damage despite showing no signs on MRI. They conducted PET scans on 22 MS patients and eight healthy controls, measuring glial activity load, a new measure developed by the researchers to assess the level of smoldering inflammation from microglia. They found that PET scans showed the hidden inflammation caused by microglia missed by MRI, and the damage to patients’ brains correlated with the patients' levels of disability and fatigue.

Furthermore, the study allowed the researchers to successfully differentiate between patients on high-efficacy and low-efficacy MS treatments. Those on low-efficacy treatments exhibited more PET scan abnormalities, indicating increased microglial activation. Conversely, patients on high-efficacy treatments showed fewer abnormalities but still displayed increased microglial activity compared to healthy individuals. This suggests that while high-efficacy treatments reduce neuroinflammation, residual inflammation persists and may contribute to the worsening of symptoms known as progression independent of relapse activity (PIRA). This research underscores the significant potential of PET scanning in detecting microglial activation, offering critical insights into managing MS more effectively.

“Our therapies are excellent in that we’ve definitely improved

guidelines

Individualized parametric z-score maps of the brain showing glial activity load on PET (GALP) in the brain, compared among secondary progressive MS (SPMS, top row), relapsing remitting MS (RRMS, middle row), and healthy controls (HC, bottom row) in transaxial, sagittal, and coronal sections. (Photo courtesty of Singhal et al., Clinical Nuclear Medicine 2024)

MS patients’ lives,” said Rohit Bakshi, MD, of the Department of Neurology. “There’s no doubt about that, but we’re still not at the finish line. This study tells us something new about the disease and may be giving us an important clue as to what is driving disease progression in patients.”

Stretchable Microneedles to Help in Tracking Abnormalities and Identifying Rapid Treatment

The field of personalized medicine is transforming rapidly, with advancements like wearable devices and home testing kits making it increasingly easy to monitor a wide range of health metrics, from heart rate to glucose levels to microbiome diversity. Despite these advancements, there is still a significant gap in integrating these technologies seamlessly with the human body, especially when it comes to invasive monitoring devices. Now, a breakthrough in research on stretchable sensors could pave the way for developing soft, flexible microneedles, enhancing both comfort and accuracy in long-term health monitoring.

Developed by researchers at the University of Southern California (Los Angeles, CA, USA; www.usc.edu), this new technology involves stretchable three-dimensional penetrating microelectrode arrays. Traditional microneedle electrodes used for brain sensing, stimulation, and

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World’s Most Powerful

MRI Sysytem Shows Living Brain with Unrivaled Clarity

The world's most powerful magnetic resonance imaging (MRI) scanner has generated its first images of the human brain, demonstrating new precision levels that could shed more light on the mysterious human mind—and the illnesses that plague them.

The Atomic Energy Commission (CEA, Paris, France; www.cea.fr) has released groundbreaking in vivo human brain images captured with the Iseult MRI machine, boasting an unparalleled magnetic field strength of 11.7 teslas. This milestone is the culmination of over two decades of research and development within the Iseult project, which aimed to construct the world's most powerful MRI machine in order to explore the human brain's anatomy, connectivity, and functions with unmatched clarity. In an initial study involving around 20 healthy volunteers, it took merely about four minutes to acquire some of the most detailed anatomical brain images ever seen, thanks to the Iseult MRI machine's advanced MRI technology and its 11.7-tesla magnetic field intensity. This level of power enables the machine to produce images with tenfold the precision of standard MRI scanners found in hospitals today. The images captured boast an extraordinary resolution — 0.2 mm in-plane resolution and 1 mm slice thickness — equivalent to the volume of several thousand neurons.

In comparison, achieving similar image quality with the 1.5 or 3 tesla MRI scanners currently in use at hospitals would take several hours, which would be impractical due to discomfort and potential movements disrupting the clarity of images. The enhanced resolution made possible by the Iseult MRI machine opens the door to gaining insights into brain mechanisms previously beyond reach, including understanding the brain's method of encoding mental representations and identifying neuronal signatures associated with the state of consciousness. The implications of this technology for medical research are profound. Firstly, it pro-

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has now been achieved by a researcher at the University of Copenhagen (Copenhagen, Denmark; www.ku.dk), who has invented a new type of sensor. This sensor operates using laser light within fiber cables and a small glass container filled with gas, proving effective in prototype tests. MRI scanners function by generating a powerful magnetic field that aligns protons in the body’s water, carbohydrates, and proteins. These protons are then disturbed by pulsed radio waves, causing them to spin out of alignment. As they realign with the magnetic field, they emit radio waves that are captured to create real-time 3D images of the targeted tissues. The new sensor precisely maps disturbances in the magnetic field,

vides ultra-detailed anatomical data crucial for diagnosing and treating neurodegenerative conditions such as Alzheimer's and Parkinson's diseases. Secondly, it enhances the ability to detect chemical species with faint signals that lower magnetic fields struggle to capture. Scientists are particularly interested in using this technology to observe how drugs like lithium, used in treating bipolar disorder, are distributed within the brain, potentially revealing which patients are more likely to benefit from specific treatments. However, the extraordinary capabilities of the Iseult MRI machine will, for the time being, remain beyond the reach of regular patient diagnostics and care.

“With the Iseult project, a whole new world is opening up before our eyes, and we are excited to explore it," said Nicolas Boulant, the Head of the Iseult project and Director of Research at the CEA. “We still need several years of research to develop and improve our acquisition methods and ensure that the data has the highest quality possible. Our goal is to investigate neurodegenerative diseases by 2026-2030, as well as other diseases that fall more under psychiatry, such as schizophrenia and bipolar disorders. Cognitive sciences will also be of key importance in our research!”

Sensor Detects Errors in MRI Scans Using Laser Light and Gas

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identifying the location and magnitude of these disruptions. This innovative development could soon allow for the correction of distorted MRI images, ensuring that they are accurate and reliable based on the sensor’s data, thus enhancing the effectiveness and reliability of MRI diagnostics. "First we demonstrated that it was theoretically possible, and now we have proven that it can be done in practice," said Hans Stærkind, the main architect behind the sensor and device that comes with it. “In fact, we now have a prototype that can basically make the measurements needed without disturbing the MRI scanner. It needs to be developed more and fine-tuned, but has the potential to make MRI scans cheaper, better and faster – although not necessarily all three at once.”

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AI Boosts Wider Use of Chest DDR

advancements have highlighted chest dynamic digital radiography (DDR) as a valuable tool for observing the lungs and diaphragm in motion, offering insights into respiratory function that static images are not capable of. Despite its potential benefits, the widespread adoption of DDR in clinical practice has been hampered by the manual, time-intensive analysis required and its unestablished correlation with standard PFT results. Now, the clinical use of chest DDR in patients with lung disorders could receive a significant boost with the development of artificial intelligence (AI) to perform the time-consuming analysis involved in the technology.

Researchers at Mount Sinai Hospital (New York, NY, USA; www. mountsinai.org) have developed a sophisticated AI "pipeline" utilizing convolutional neural networks (CNNs) to analyze sequences of DDR images of the lungs from patients. This approach aims to replicate the results of standard pulmonary function tests, effectively bridging the gap between DDR technology and conventional respiratory assessment methods. They created two specific CNNs for evaluating key aspects of lung movement in DDR sequences, using data from 55 patients representing a spectrum of lung health - from normal to those with obstructive and restrictive lung conditions. These CNNs were tasked with measuring lung areas in the images, essentially creating DDR-based pulmonary function tests (dPFTs). The researchers then undertook a comparative analysis of dPFTs against standard PFT measurements.

Their findings revealed statistically significant and strong correlations between the dPFT measurements and traditional PFT values, including total lung capacity, forced expiratory volume in one second, vital capacity, and functional residual capacity. These correlations indi-

cate that dPFTs could potentially serve as alternatives to conventional PFTs, especially in scenarios where traditional tests are not feasible or available. DDR presents several advantages over conventional methods, including reduced radiation exposure compared to standard chest X-rays and the ability to provide valuable diagnostic information in situations where PFTs are inaccessible, such as for patients with neuromuscular disorders or during acute exacerbations of chronic obstructive pulmonary disease, concluded the researchers.

“Our study demonstrates robust dPFTs and PFTs correlations using an automated DDR analysis pipeline. This pipeline has potential to discern normal from abnormal physiology, suggesting dPFTs are valuable in assessing lung dynamics,” concluded the researchers.

Stretchable Microneedles to Help in Tracking Abnormalities and Identifying Rapid Treatment

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biomarker diagnosis are generally rigid, which limits their application. The new soft microneedle electrodes are specifically designed to be adaptable with muscle and skin tissues that often deform, ensuring continuous contact and minimizing tissue damage. This adaptability is crucial for accurate health monitoring, from assessing bladder function to detecting subtle changes in cardiac rhythms.

This advancement is made possible by a hybrid fabrication method that combines laser micromachining, microfabrication, and transfer printing. This method is both low-cost and scalable, offering un-

precedented stretchability in microneedle electrodes—60-90%—the highest ever reported. It also allows for the customization of electrode geometry, recording sites, and the mechanical and electrical properties of the device. An interesting feature of the research is its deep-sea origins, with the technology used to record electrical activity in the moving muscles of a sea slug. This novel platform technology suggests the potential of these microneedle electrodes for broader biomedical applications, including brain and nerve activity monitoring, electrochemical skin sensing, neuromuscular disorder diagnosis, and deep tissue drug delivery.

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Image: AI could help chest DDR achieve clinical adoption (Photo courtesy of 123RF)

Bioelectronic Mesh Grows with Cardiac Tissues for Heart Monitoring

Heart disease remains the top cause of death worldwide. The ability to monitor heart tissue in real time is significantly limited. Implanting sensors in the heart is risky, and the heart's complexity—its mechanical actions of pumping blood and the electrical signals controlling those actions—demands monitoring of more than one characteristic at a time. However, traditional sensors can only track one feature, and a device capable of measuring both would be too large, potentially affecting the heart's function. Until now, no single sensor could assess both the heart's mechanical and electrical activities without affecting its operation. Now, researchers have created a bioelectronic mesh embedded with graphene sensors that can record the electrical signals and movements of cardiac tissue at the same time.

The tissue-like bioelectronic mesh system developed by a team of engineers led by the University of Massachusetts (Amherst, MA, USA; www.umass.edu) is integrated with an array of atom-thin graphene sensors and can simultaneously measure both the electrical signal and the physical movement of cells in lab-grown human cardiac tissue. This breakthrough allows for observation of

without disrupting the heart's operations.

Embedded in a soft, stretchable, porous mesh scaffold that mimics human tissue, these graphene sensors can non-invasively attach to cardiac tissue, remaining stable and conductive over time. This allows for continuous monitoring of the CMT's development. This device is a significant advancement for cardiac disease research and the study of drug therapies' potential side effects. Going forward, the researchers aim to expand this technology for broader applications, including in vivo monitoring, to gather precise data to combat heart disease.

Image: The bioelectronic mesh can measure electrical signal and movement of cardiac tissue at the same time (Photo courtesy of UMass Amherst)

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Faster Diagnosis and Prediction of Sepsis

their lives even after discharge. Now, a revolutionary artificial intelligence (AI) diagnostic and predictive tool for early sepsis detection has significant potential to save lives and reduce hospital length of stay.

The Sepsis ImmunoScore from Prenosis (Chicago, IL, USA; prenosis. com) is an AI software as a medical device (AI SaMD) for guiding the rapid diagnosis and prediction of sepsis. It assesses the risk of sepsis onset or progression within 24 hours following a patient's evaluation in emergency or hospital settings. By analyzing a comprehensive array of 22 biomarkers and clinical data points, the Sepsis ImmunoScore evaluates the patient's overall biological state, providing a risk score and categorizing patients into four distinct risk levels. These classifications are indicative of potential clinical outcomes, such as hospital stay duration, mortality risk, and the necessity for escalated care measures like ICU admission, mechanical ventilation, or vasopressor administration within the next 24 hours. By integrating seamlessly into hospital electronic health records (EHRs), Sepsis ImmunoScore’s software becomes easily accessible to clinicians. It features a user-friendly interface that details the contribution of each parameter to the overall sepsis risk assessment, fostering a transparent relationship between clinicians and the AI tool. This transparency is crucial for encouraging rapid and informed clinical decisions, thereby enhancing patient care quality and hospital efficiency. The Sepsis ImmunoScore was built using the Immunix precision medicine platform from Prenosis which is designed to advance personalized medicine in acute care settings. The U.S. Food and Drug Administration (FDA) has granted marketing authorization for the Sepsis ImmunoScore using the De Novo pathway, making it the first-ever AI sepsis diagnostic to be granted marketing authorization by the FDA.

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Image: The Sepsis ImmunoScore is the first-ever AI sepsis diagnostic granted marketing authorization by the FDA (Photo courtesy of Prenosis)

"FDA authorization of a sepsis diagnostic tool with significant predictive power is a landmark event for people that could ever be at risk of sepsis at some point in their lives," said Bobby Reddy, Jr, Ph.D., Prenosis Co-Founder and CEO. "Until now, there was no other FDA authorized AI diagnostic for sepsis, which is why the Sepsis ImmunoScore had to be granted marketing authorization through the De Novo pathway. FDA authorization offers yet another important piece of evidence of the potential of the Sepsis ImmunoScore to improve care."

Low-Energy Defibrillation Method Controls Cardiac Arrhythmias

n a healthy heart, electrical impulses spread across the heart muscle in an orderly way, controlling the heart’s contractions: the ventricles and atria contract and relax at regular intervals. However, in the case of cardiac arrhythmia, these electrical pulses may spread chaotically, disrupting the regular heartbeat and impairing proper blood circulation. Atrial fibrillation is the most prevalent type of cardiac arrhythmia, affecting over 10 million individuals in Europe and the US. For those with chronic atrial fibrillation, a common remedy is defibrillation, which involves a strong electric pulse that, although effective, can be painful and potentially harmful to surrounding tissues. Now, researchers have introduced a new low-energy defibrillation method that could stop life-threatening heart fibrillations more gently.

The new technique called LEAP (Low-Energy Anti-fibrillation Pacing) has been developed by an international team of scientists led by the Max-Planck-Institute (MPI, Munich, Germany; www.mpg.de) and reduces the energy needed for defibrillation by over 80% compared to traditional methods, offering the potential for the pain-free treatment of severe cardiac fibrillation. This method involves delivering a sequence of five mild electrical signals through a cardiac catheter, allowing the heart to resume its normal rhythm within seconds. Unlike conventional defibrillators that excite all cells at once with a strong electric field, LEAP works by briefly halting the ability of heart tissue to transmit electrical signals, effectively resetting the heart's activity.

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Low-Energy Defibrillation Method Controls Cardiac Arrhythmias

This innovative approach is similar to rebooting a malfunctioning computer. However, instead of a single reset, LEAP uses low-energy pulses to synchronize the tissue to gradually stop the turbulent electrical activity in the heart which later resumes normal beating. Research involving experiments and simulations has shown that natural heterogeneities within the heart, such as blood vessels and areas of fatty or fibrotic tissue, can act as the origins for synchronizing waves. The findings suggest that LEAP could also be adapted for treating ventricular fibrillation, a more severe arrhythmic event typically managed only with external or implantable defibrillators. For the many patients who rely on implantable cardioverter-defibrillators (ICD), LEAP could potentially enhance treatment efficacy, extend battery life, reduce painful experiences, and decrease the frequency of surgical interventions to replace devices.

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Spatial-temporal excitation pattern during cardiac fibrillation on the surface of heart (field of view 6 x 6 cm2). Color code: black = resting, yellow = excited (Photo courtesy of MPI for Dynamics and Self-Organization)

"The development of LEAP is a groundbreaking result and an outstanding example of successful interdisciplinary collaboration between physicists and physician-scientists, with immediate impact on the development of novel therapies for life-threatening cardiac arrhythmias," said Markus Zabel from the University Center Göttingen.

Preventive PCI for High-Risk Coronary Plaques Reduces Cardiac Events

laques building up in the heart’s arteries that comprise fats, cholesterol, and other substances, can lead to heart attacks and serious cardiac events if they break off and travel through the blood vessel to cause a blockage. Percutaneous coronary intervention (PCI) is used to open blocked arteries for treating myocardial ischemia, a condition where the heart muscle fails to receive enough oxygenated blood. During PCI, a stent is inserted through a catheter into the blocked artery from the groin or arm, which not only keeps the artery open for blood to flow freely but also releases medications to prevent further plaque buildup. The concept of preventive PCI is based on the view that a stent could stabilize high-risk plaque lesions, thus lowering the chance of rupture and a potential heart attack. Now, a new study has found that individuals with a buildup of fatty atherosclerotic plaque in the heart’s arteries considered at risk of rupturing can benefit significantly from PCI, reducing the likelihood of severe cardiac events compared to treatment with medication alone.

The findings of the new research presented at the American College of Cardiology’s 2024 Annual Scientific Session by researchers from the University of Ulsan (Seoul, South Korea; www.uuh.ulsan.kr) suggest that individuals having high-risk plaques that are likely to rupture stand to benefit from preventive PCI instead of waiting for a heart attack or other serious reduction in blood flow to happen. The PREVENT trial is notably the most extensive study on preventive PCI to date as it focuses

on patients with non-symptomatic or non-ischemic blockages that typically wouldn't warrant PCI under current care standards. It is also the first study with a large enough sample size to examine the clinical outcomes of using preventive PCI for treating vulnerable plaques. The trial found that, after two years, participants who underwent preventive PCI had an 89% lower risk of experiencing serious cardiac outcomes such as cardiac death, heart attack in the targeted vessel, revascularization due to ischemia in the target vessel, or hospitalization for unstable or progressive chest pain, compared to those on medication alone.

The study involved 1,606 coronary artery disease patients from 15 centers across four countries, all with plaques identified as vulnerable to rupture through intravascular imaging but not significantly obstructing blood flow. Participants, averaging 64 years old, were either assigned to PCI combined with medical therapy or to medical therapy only, which included lifestyle changes and intensive pharmacologic treatment per secondary prevention guidelines, with a strong emphasis on high-dose statin therapy for both groups. Two years into the study, the composite primary endpoint occurred in three patients who underwent PCI (0.4% of the PCI group) and in 27 patients who were administered only medications (3.4% of the controls), marking an 89% lower risk of the composite primary endpoint among those who received PCI. The cumulative incidence of this composite endpoint was found to be

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Image:

Detection and Treatment of Nerve-Related Disorders Combined in Single Procedure

tivity, disruption, or dysfunction in the PNS can lead to numerous health issues, including pain, cardiovascular diseases like hypertension, and gastrointestinal disorders. Now, a first-in-class technology platform comprising a catheter-based microchip sensing array can detect and differentiate neural signals as well as perform nerve ablations, killing the nerves that are misfiring to relieve pain. This technology can sense individual neural signals with sensitivity up to 3,000 times greater than current methods, revolutionizing the field of electrophysiology and pain management.

Autonomix Medical’s (The Woodlands, TX, USA; autonomix.com) catheter-based technology offers a comprehensive solution by combining the detection and treatment of nerve-related disorders in a single procedure, thereby streamlining the process and enhancing patient outcomes. This two-fold technology operates with the precision of a smart bomb, allowing physicians to accurately target specific target nerves that are misfiring and eliminate them through ablation or burning to relieve pain. This method is superior to conventional treatments used by doctors to treat suspected areas by attempting to hit the right nerves that can be imprecise, miss the intended nerves, and damage the surrounding ones.

Preventive PCI for High-Risk Coronary Plaques Reduces Cardiac Events

from page 14

significantly lower in the PCI group through long-term follow-up over a median of 4.4 years (maximum up to 7.9 years), with patients receiving PCI demonstrating a 46% lower risk of the composite endpoint across this period. Additionally, the rates for each component of the composite primary endpoint were also found to be lower in the PCI group, in line with the composite rate of death from any cause or heart attack in the target vessel or any revascularization.

“PREVENT has now shown that preventive PCI may reduce the two-year and long-term risks of major cardiac events arising from vessels containing vulnerable plaques,” said Seung-Jung Park, MD, the study’s lead author. “These findings demonstrate that the focal treatment of high-risk vulnerable plaques may improve patient prognosis beyond optimal medical therapy alone.”

Autonomix’s breakthrough technology employs its proprietary microchip and a unique antenna sensing array to deliver accurate treatments via a safe and simple transvascular procedure. The microchip converts signals from the body into digital signals sent directly to a computer screen. This eliminates the need for the faint neural signals to travel through several feet of wires and allows them to be read on the spot. The sensing antenna can detect exceptionally weak neural signals, as low as 0.5 microvolts, compared to the 10-15 microvolts required by existing technologies. Its novel basket design allows locating neural signals in a 3D space to enable the highest level of precision treatment. This technology is applicable for treating various diseases associated with nervous system dys-

regulation. Initially, Autonomix is focusing on alleviating pain in patients with pancreatic cancer or pancreatitis, who do not find relief from current treatments. The company has secured a US patent for its proprietary catheter-based technology for managing cancer-related pain.

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Image: The catheter is equipped with a microchip (Photo courtesy of Autonomix Medical)

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Transcatheter Valve Replacement Outcomes Similar To Surgery

new study has shown that a minimally invasive procedure for replacing the aortic valve in the heart—known as transcatheter aortic valve replacement (TAVR)—is on par with the more traditional surgical aortic valve replacement (SAVR).

In a meta-analysis conducted by researchers at the University of Sassari (Sassari, Italy; www.uniss.it), they evaluated seven randomized trials involving 7,785 patients who underwent TAVR—a procedure that introduces a new aortic valve via a catheter—or SAVR for severe aortic

stenosis. The findings revealed no significant differences in the rates of death or disabling stroke between the TAVR and SAVR groups, with both showing similar long-term mortality risks. These results held true across various surgical risk profiles, including low, intermediate, and high risk. However, compared to SAVR, TAVR was linked to a higher likelihood of requiring a pacemaker and experiencing moderate-tosevere paravalvular leaks.

Furthermore, the study conducted a prespecified analysis comparing the outcomes associated with two different types of TAVR devices against SAVR. This analysis found that, relative to SAVR, self-expanding TAVR prostheses had a lower risk of death or stroke, valve thrombosis, and valve gradients, but a higher rate of pacemaker implantation compared to balloon-expandable TAVR devices, underscoring potential long-term differences between these two percutaneous TAVR options.

“This study represents the largest scale analysis so far available comparing longer-term percutaneous devices for aortic valve replacement versus surgery,” said study coauthor Eliano Pio Navarese, MD, PhD, head of clinical experimental cardiology and associate professor at the University of Sassari. “Our findings support the comparable long-term safety and efficacy of TAVR, as well as raise important considerations for valve type selection, particularly when we are dealing with longer-term valve durability and pacemaker implantation.” The study was published in the journal JSCAI on May 15, 2024.

Revascularization Improves Life Quality in Chronic Limb-Threatening Ischemia

esearchers have undertaken a detailed study to evaluate the effects of revascularization strategies on the healthrelated quality of life (HRQoL) of patients with chronic limb-threatening ischemia. Their study marks a significant initiative for comparing the effectiveness of surgical bypass (Bypass) versus endovascular intervention (Endo) among different patient groups.

The study by researchers at Harvard Medical School (Boston, MA, USA; hms.harvard.edu) divided patients into two groups based on whether they had a single-segment great saphenous vein available—a critical factor for surgical bypass procedures. HRQoL was measured using a range of tools, including Vascular Quality-of-Life (VascuQoL), European Quality-of-Life-5D (EQ-5D), the Short Form-12 Physical and Mental Component Summaries (SF-12 PCS & MCS), Utility Index Score (SF-6D R2), and various numeric pain rating scales. A mixedmodel linear regression was applied to compare HRQoL outcomes both within and between the treatment groups throughout the trial's duration.

The study included 1193 patients in cohort 1 and 335 patients in cohort 2, with average follow-up times of 2.9 and 2.0 years, respectively. The results indicated significant improvements in HRQoL from baseline to follow-up across all measured parameters for both cohorts. Notably, in cohort 1, several HRQoL measures including VascuQoL, SF-12 MCS, SF-6D R2, and various pain scales showed

a preference for the Endo group. While these differences were statistically significant, they did not reach a threshold that would be considered clinically meaningful. In contrast, cohort 2 showed no significant differences between the Bypass and Endo groups in any HRQoL measures.

The study conclusively demonstrated that revascularization, whether by Bypass or Endo, significantly improves HRQoL for patients suffering from chronic limb-threatening ischemia. For patients with an available single-segment great saphenous vein, Endo slightly outperformed Bypass in some HRQoL measures, though the differences were not clinically significant. These findings highlight the effectiveness of revascularization in enhancing quality of life for patients with this severe condition, regardless of the method used. The study was published in the journal Circulation on April 12, 2024.

"In patients with chronic limb-threatening ischemia deemed eligible for either Bypass or Endo, revascularization resulted in significant and clinically meaningful improvements in HRQoL,” said Dr. Christopher White, a contributing author to the study. “The results of the BESTCLI trial underscore the profound impact revascularization can have on patients' lives, not just in terms of physical health but also in their overall quality of life. These findings highlight the importance of patient-centered care approaches in vascular surgery and the need for continued innovation in treatment strategies."

First Global Guidelines to Reduce Bloodstream Infections from Catheter Use

p to 70% of all inpatients require a catheter, specifically a peripherally inserted catheter (PIVC), at some point during their hospital stay. Patients who receive treatments via catheters are particularly vulnerable to infections due to potential serious illnesses or compromised immune systems. Infections can arise from poor practices in the insertion, maintenance, and removal of these catheters, leading to severe outcomes like sepsis and complications in vital organs such as the brain and kidneys. Infections can also occur at the catheter’s insertion site.

The World Health Organization (WHO, Geneva, Switzerland) has released the first-ever global guidelines aimed at preventing bloodstream and other infections associated with catheters placed in minor blood vessels during medical procedures. From 2000 to 2018, WHO reports

show that the average mortality rate among patients who suffered from healthcare-associated sepsis was 24.4%, which rose to 52.3% among those in intensive care units. A significant number of these infections are linked to bacteria resistant to antibiotics. It is estimated that bacterial antimicrobial resistance (AMR) directly caused at least 1.27 million deaths and was associated with an additional 4.95 million deaths in 2019. Addressing the spread of such infections is a critical focus for WHO.

The newly issued guidelines comprise 14 good practice statements and 23 recommendations that focus on essential practices for health workers. These include education and training, techniques for asepsis, hand hygiene, procedures for the insertion, maintenance, access,

Wheeze-Counting Wearable Device Monitors Patient's Breathing In Real Time

Lung diseases like asthma, chronic obstructive pulmonary disease (COPD), lung cancer, bronchitis, and infections such as pneumonia, rank among the leading causes of death worldwide. Traditionally, medical professionals diagnose these conditions by listening to a patient's breathing using a stethoscope to detect abnormal sounds like wheezing or crackling, which are common indicators of many lung and respiratory diseases. This diagnostic method demands significant expertise, and misinterpreting these sounds can result in incorrect diagnoses. Researchers have now developed an artificial intelligence (AI) algorithm that continually monitors a patient’s breathing and issues early medical alerts for potential asthma attacks or other respiratory issues.

Developed by a team at the University of Texas at Dallas (Richardson, TX, USA; www.utdallas.edu), this algorithm monitors a patient’s breathing in real time and analyzes the frequency of wheezes. This enhances the monitoring of lung sounds for symptom prevention, early detection of respiratory diseases, and symptom alleviation. The research team trained their deep-learning model using a dataset comprising 535 respiration cycles from various patient data sources to identify breathing patterns indicative of asthmatic symptoms. This innovative wheeze counter is poised to transform the approach to predicting lung diseases based on long-term breathing patterns.

The challenge in a clinical setting is continuously monitoring the pattern and frequency of abnormal lung sounds over extended periods, which is currently impractical. The algorithm developed addresses this by not only identifying abnormal sounds in each breath but also by capturing a comprehensive set of data that includes atypical breathing patterns. The next step for the researchers is to integrate this technology into a wearable device, allowing for its use in both clinical and non-clinical settings to facilitate on-the-go detection and remote medical interventions. Going forward, the team aims to combine real-time air pollution readings with real-time breathing sound analysis into a single wearable device to offer continuous monitoring of respiratory health.

“We developed the deep-learning algorithm to detect automatically whether someone’s breathing is problematic. When someone is wheezing, the algorithm will count the number of incidences and analyze their timing,” said Dr. Dohyeong Kim, a University of Texas at Dallas researcher. “Our wheeze-counting method is straightforward

yet effective, with potential for expansion into automatic symptom monitoring. This could be crucial in predicting the onset or severity of future abnormalities, as well as detecting current symptoms.”

Image: An algorithm can provide early medical alerts about the onset of respiratory problems (Photo courtesy of 123RF)

First

Global Guidelines to Reduce Bloodstream Infections from Catheter Use

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and removal of catheters, and criteria for catheter selection. WHO is committed to collaborating with countries to adopt and promote these best practices to diminish the incidence of bloodstream infections in hospital settings and ensure that all patients receive care that is both safe and effective.

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Wireless Implantable Temperature Sensor Monitors Chronic Inflammatory Bowel Disease

rohn’s disease is a chronic inflammation of the intestines that leads to digestive problems, weight loss, malnutrition, and various complications. For those with mild symptoms, oral medications are common treatments. However, these medications often lose effectiveness over time, resulting in about 70% of individuals with Crohn’s disease requiring surgery to remove damaged parts of their intestines at some point. Detecting inflammatory flare-ups early has been a challenge for doctors, with many episodes going unnoticed by patients until they become severe, necessitating invasive surgery.

Researchers have now created the first-ever wireless, implantable sensor that can monitor temperature changes in the gut, signaling inflammation in real-time in Crohn’s disease patients. This innovation allows for continuous monitoring, potentially allowing doctors to intervene earlier to prevent or minimize damage from inflammation.

Developed by researchers at Northwestern University (Evanston, IL, USA; www.northwestern.edu), this highly miniaturized sensor resembling a small, round capsule is designed for wireless communication and can be smoothly integrated into the gastrointestinal system. It functions without disrupting natural bodily processes, enabling extended monitoring periods. The research team tested this temperature sensor in mice with Crohn’s disease to see if it could provide immediate feedback on disease progression and detect sudden inflammatory flare-ups. Over nearly four months, continuous temperature monitoring by these wireless sensors revealed distinctive patterns, including changes in the natural circadian rhythms, known as ultradian rhythms, which signaled the start of inflammatory responses. They also noticed a gradual decrease in the average intestinal temperature over weeks to months, correlating with the decline in tissue health. This approach of tracking temperature changes could benefit not just Crohn’s disease patients but also those with ulcerative colitis or any condition characterized by long-term inflammation. After demonstrating success in mouse models, the team is now looking to evaluate the sensor's effectiveness in human tissues that simulate the inflammatory conditions found in inflammatory bowel disease.

“The magnitude of the flare-up can be measured with regards to the heat signature,” said Arun Sharma, a research associate professor of urology at Northwestern University Feinberg School of Medicine. “Is it so extensive that it’s going to cause tissue damage over time? This could be potentially prevented if a clinician has this information readily at hand and can determine what type of therapy can be given to that person at that moment in time, rather than waiting weeks to get a blood analysis, tissue biopsy or fecal analysis. In the meantime, you’re losing valuable minutes regarding tissue damage with this inflammatory event.”

Image: The miniaturized implantable temperature sensor on the finger (Photo courtesy of Northwestern University)

Imaging Platform Detects Residual

Breast Cancer Missed in Lumpectomy Surgery

reast cancer is becoming increasingly common, with statistics indicating that 1 in 8 women will develop the disease in their lifetime. Lumpectomy remains the predominant surgical intervention for treating breast cancer, yet surgeons frequently face challenges in completely removing the tumor in the initial surgery. Current intraoperative tools are insufficient for accurately delineating the tumor boundary, leading to incomplete tumor resections. As a result, up to 36% of patients undergo a second surgery, though in up to 65% of these cases, no residual cancer is found, raising concerns about the need for such additional surgeries due to potential false positive margin assessments or missed cancer in the follow-up procedure. Now, a new technology that is clinically proven to help physicians achieve a more complete cancer resection during lumpectomy could help prevent a second surgery for some patients.

Lumicell’s (Newton, MA, USA; lumicell.com) LumiSystem, comprising LUMISIGHT (pegulicianine) optical imaging agent and Lumicell Direct Visualization System (DVS), has an 84% diagnostic accuracy in detecting residual cancer, in real-time, that could be otherwise missed during lumpectomy surgery, while helping some patents avoid second surgeries. The LumiSystem combination is indicated for fluorescence imaging in adults with breast cancer as an adjunct for the intraoperative detection of cancerous tissue within the resection cavity following the removal of the primary specimen during lumpectomy surgery.

The system’s efficacy and safety have been confirmed through data gathered from over 700 breast cancer patients participating in five clinical studies across leading academic and regional community cancer centers in the U.S. Common side effects associated with LUMISIGHT include hypersensitivity reactions and discoloration of the urine. There are risks of severe hypersensitivity reactions, including anaphylaxis. The U.S. Food & Drug Administration (FDA) has now approved the company’s New Drug Application (NDA) for LUMISIGHT and its Premarket Approval (PMA) application for Lumicell DVC. LUMISIGHT and Lumicell DVS had previously received FDA Fast Track and Breakthrough Device designations, respectively.

“We are immensely proud of the dual approval of LUMISIGHT and Lumicell DVS – we believe this is the first drug-device combination product approved in over a decade to have followed both of the FDA's most stringent NDA and PMA review processes,” said Howard Hechler, President and Chief Operating Officer, Lumicell. “With the FDA’s approval, LumiSystem is now the first and only imaging combination product capable of detecting cancerous tissue where it matters most, inside the breast cavity.”

Novel Technology Monitors and Lowers Bleeding Complications in Heart Procedures

Bleeding complications at the femoral access site can significantly hamper recovery, affecting the success of procedures, patient satisfaction, and overall healthcare costs. It is crucial for surgeons to quickly identify any bleeding to prevent minor bleeds from turning into serious complications. Now, a novel monitoring device offers real-time detection of bleeding during endovascular procedures, ensuring better outcomes and providing peace of mind for patients at high risk of bleeding.

The Early Bird Bleed Monitoring System (EBBMS) from Saranas, Inc. (Houston, TX, USA; saranas.com) is the only FDA-approved system for real-time bleed monitoring, marking a significant step forward in reducing healthcare expenses and enhancing patient care during endovascular procedures. The system employs the Bleed Detection Array to generate bioimpedance signals that track bleeding status, with simple indicators alerting surgeons to potential bleeds and signaling when intervention is necessary. Both animal studies and clinical trials have consistently shown a direct correlation between reduced bioimpedance levels and increased bleed volume. Early Bird can identify bleed progression with a statistically significant increase in volume detected at each bleed indicator level.

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Image: LUMISIGHT and Lumicell DVS offer 84% diagnostic accuracy in detecting residual cancer (Photo courtesy of Lumicell)

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Catheter System Enables Safer, More Cost-Effective Transseptal Procedures

n 2021, cardiologists performed around 375,000 transseptal left heart procedures in the U.S., including closures, valvuloplasty, repairs, septostomies, and electrophysiology, with this number expected to rise to approximately 900,000 by 2025. One significant challenge is the corresponding rise in procedural complications. While the incidence of complications is relatively low — for instance, 1-2% of procedures using transesophageal echo (TEE) result in accidental perforations — the sheer volume of septal procedures can increase the total number of adverse events manifold. Such complications can have devastating consequences for patients, underscoring the urgent need for innovations to mitigate these risks. Now, a unique dual-lumen catheter enhances the safety and precision of transseptal procedures by offering superior visualization of the catheter, needle, and needle tip, as well as facilitating the safer transfer of intracardiac echocardiography (ICE) and other catheters/wires from the right to the left atrium of the heart. Traditionally, transseptal procedures have relied on either inserting an ICE catheter directly into the heart or using a TEE imaging catheter in the esophagus to produce ultrasound images that guide the transseptal puncture needle and the treatment catheter throughout the procedure. The ICE catheter approach necessitates the employment of dual systems: one sheath for the transeptal needle and another for the ICE catheter, which emits an ultrasound beam from differing planes, resulting in only partial, intermittent imaging. This setup only partially and intermittently displays the catheter and needle orientation and the depth of the needle tip in relation to the cardiac structure. Similarly, the TEE approach, besides requiring general anesthesia, presents similar challenges. The UltraNav Transseptal Catheter System from

Franklin Mountain Medical (Scottsdale, AZ, USA) is a unified system that aligns the catheter/needle with the ultrasound beam along the same plane, allowing cardiologists to achieve more accurate, continuous, and comprehensive visualization. This advancement not only minimizes the risk of complications but also ensures better alignment of the catheter.

By offering continuous visualization— as opposed to intermittent views— the UltraNav system significantly reduces visual interruptions caused by the cardiac and respiratory movements of the patient. Housed within the UltraNav system are the needle and ICE, simplifying atraumatic passage from the right to the left atrium and easing the transport of additional catheters/wires. Compatible with existing needles, VersaCross RF wires, and various ICE catheters, this system guarantees more precise and uninterrupted visualization during transseptal procedures, facilitating safer septum puncture. Cardiologists are provided a full view of the heart’s internal structure and the instruments in use, enhancing procedural effectiveness, minimizing complications, and improving overall success rates. Furthermore, because the UltraNav technique only necessitates moderate sedation instead of general anesthesia, patients benefit from quicker recovery times and can avoid overnight hospital stays, thereby reducing hospital costs and optimizing resource use while ensuring a safer and more positive experience for the patient.

"Although the current transeptal crossing complications are in the 2-4 percent range, they can be significant,” said Dr. Nabil Dib, inventor of the UltraNav Transseptal Catheter System. “UltraNav reduces these complications, the need for anesthesia, and the complexity of the ICE procedure. It is helping physicians treat more patients and meet the increased demand for these procedures."

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Novel Technology Monitors and Lowers

Bleeding Complications in Heart Procedures

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The "SAFE-MCS" study, a multi-center U.S. clinical trial, has assessed the safety of performing complex, high-risk percutaneous coronary interventions (PCI) with mechanical circulatory support (MCS) and monitoring with EBBMS. PCI is a non-surgical method for treating coronary artery blockages and restoring blood flow to the heart. This study, involving 203 patients from various U.S. centers, showcased EBBMS's capability to identify and mitigate bleeding complications during protected PCI. Protected PCI, which uses MCS to temporarily support the heart's pumping action, is a recognized treatment method. This pioneering study focused on bleeding complications during protected PCI, highlighting a significant decline in such complications among patients monitored with EBBMS.

Image: The UltraNav Transseptal Catheter System houses a needle and ultrasound in one system (Photo courtesy of Dib UltraNav Medical)

Living Knee Replacement to Revolutionize Osteoarthritis Treatment

Osteoarthritis is the most prevalent type of arthritis, characterized by the progressive deterioration of cartilage, or the protective tissue covering the bone ends, resulting in pain, stiffness, and impaired movement. This condition ranks as the third leading cause of disability and imposes an economic impact exceeding USD 136 billion annually. Its incidence is notably higher among women, older adults, certain racial and ethnic groups, and individuals from lower socioeconomic backgrounds, with knee osteoarthritis incidents rising due to the aging population, more frequent joint injuries, and notably, an increase in obesity.

Currently, the standard clinical remedy for severely damaged knee joints due to osteoarthritis or traumatic injuries involves total joint replacement using prosthetics composed of metal and plastic. Despite the widespread success of knee replacements, these traditional materials come with significant downsides, including the potential for infection, loosening, mechanical failure, stiffness, unnatural knee movement, instability, and continuous pain. Moreover, these knee replacements typically last 15 to 20 years, requiring subsequent replacements in younger patients due to wear and tear of the plastic components or loosening of the implant.

A team of biomedical engineers from Columbia University (New York, NY, USA; www.columbia.edu) is col laborating with orthopedic surgeons to build a living replacement knee from biomaterials and human stem cells, including a patient’s own cells. The development of NOVAJoint, the revo lutionary biocompatible, low-cost, pa tient-specific knee joint replacement, builds upon more than two decades of collaborative musculoskeletal research at Columbia in engineering and med icine, and could provide a transfor mative solution for millions of people globally who suffer from osteoarthritis. NOVAJoint aims to address the urgent, unmet clinical need for a permanent solution for patients with advanced osteoarthritis where a conventional knee replacement is required.

The project’s goal is to engineer a knee replacement composed of regen erated living cartilage and bone that seamlessly integrates with the body's native bone, restoring pain-free joint function. Taking into account the fact that cells are required to regenerate and maintain this living implant, two versions of NOVAJoint will be created: one utilizing the patient's cells and another employing donor cells. NOVAJoint is expected to significantly prolong the lifespan of the implant, minimize complications, and serve as a definitive treatment for knee osteoarthritis. The project timeline is ambitious, with plans to develop the initial prototypes within the first two years, followed by preclinical and clinical trials in the subsequent three years, including a Phase 1 safety clinical trial in the final year.

“This is a big challenge, but by creating a large and experienced team that works well together and can be focused on one goal, we expect to succeed,” said Nadeen O. Chahine,

Image: The living replacement knee will be tested in clinical trials within five years (Photo courtesy of ARPA-H)

TTo

ELECTROSURGICAL UNIT

The ARC 350 is an electrosurgical unit with a touch-assisted universal system for almost all areas of electrosurgery and also offers indication-oriented modes for specific adjustment and quick, easy application.

MOBILE VIDEO ENDOSCOPY SYSTEM XION MEDICAL

The EndoPORTABLE Veezar mobile video endoscopy examination system consists of a tablet PC designed for medical use, an EndoPORTABLE Veezar Adapter permanently attached to the side, and the flexible FN10 or FN20 video endoscopes.

Signaling Method Enables Precise Localization of Miniature Robots and

Surgical Instruments Inside Body

he advent of nanorobots capable of autonomous movement within the human body, tasked with drug delivery, conducting tissue measurements, or executing minor surgeries, marks a significant leap in medical technology. While scientists have developed magnetically driven prototypes capable of traversing through muscle tissue, the vitreous humor of the eye, or the vascular system, the real-time monitoring and control of these robots deep within the body remains a challenge. Conventional imaging methods fall short: MRI's temporal resolution is too low, CT scans carry the risk of radiation exposure, and ultrasound's effectiveness is diminished by strong scattering of sound waves. Scientists have now developed a signaling method based on an oscillating magnet that can significantly improve such medical applications.

A team of scientists at the German Cancer Research Center (DKFZ, Heidelberg, Germany; www.dkfz.de) has developed a tiny device based on a magnetic oscillator—essentially a magnet that vibrates mechanically within a millimeter-sized housing, set into motion by an external magnetic field. This signal can be recorded using magnetic sensors when the oscillation subsides again, based on the same prin-

ciple applied to nuclear magnetic resonance in MRI. This technique, dubbed "Small-Scale Magneto-Oscillatory Localization" (SMOL), boasts the capability to accurately determine the position and orientation of the small device from a considerable distance (beyond 10 cm), with outstanding precision (under 1 mm), and in real-time.

As compared to conventional static magnet-based tracking methodologies, SMOL can detect movements in all six degrees of freedom and with significantly higher signal quality. Given its reliance on weak magnetic fields, it poses no risk to human health, offers wireless operation, and seamlessly integrates with a wide variety of existing medical devices and imaging technologies, heralding a new era in the precision and safety of internal medical procedures.

"There are many possible applications for the SMOL method," said research scientist Felix Fischer. "We have already integrated the system into miniature robots and instruments for minimally invasive surgery. A combination with capsule endoscopes or the marking of tumor tissue for very precise radiotherapy would be conceivable. Our method could also provide a decisive advantage for fully automated surgical robotics or augmented reality applications."

Biomaterial Combined with Microsurgical Approach Speeds Up Soft Tissue Recovery

buildup post-surgery), infection, and reconstructive failure. To speed up the formation and patterning of new blood vessels, researchers have combined a novel biomaterial with a microsurgical approach used in reconstructive surgery, allowing for improved soft tissue recovery.

The research team at Penn State (University Park, PA, USA; www. psu.edu) showed that their technique could accelerate the formation of guided networks of blood vessels through a proof-of-concept seven-day experiment. The researchers had previously engineered granular hydrogel scaffolds (GHS), which are unique biomaterials made from packed gel particles or microgels. Unlike bulk hydrogels, which are commonly used in surgery as a base for revascularization of tissues, GHS enables the blood vessels to regrow in a set pattern. This is in contrast to bulk hydrogels, where the blood vessels adopt a random appearance as they regrow in bulk hydrogels. According to the researchers, their approach could enable tissue repair and regeneration across the body.

Their surgical method employs micropuncture, a technique involving the perforation of an existing blood vessel with a fine needle. This assists cells in rapidly migrating to the surrounding tissue, promoting

angiogenic outgrowth – the extension of new blood vessels from existing ones. Micropuncture also minimizes the risks of blood clotting and significant hemorrhaging, common in conventional vascular surgery. After creating the micropuncture, GHS is applied to the wound area, providing a scaffold for blood vessel formation. The distinct void architecture of GHS provides the parameters required to guide the blood vessels as they grow. The effectiveness of the GHS/microsurgery technique was tested on the hind limbs of rats and revealed the formation of blood vessels around the GHS within seven days, without any adverse effects. Additionally, by using GHS of different microgel sizes, researchers could control the distances between capillaries in the resulting vascular pattern.

“Our approach may open opportunities to redefine the tissue vascularization landscape, with widespread applicability in many parts of the human body and for various diseases, including cardiovascular-related ones,” said corresponding author Amir Sheikhi. “We strongly believe that this novel platform of GHS and microsurgery for reconstructive surgery and regenerative medicine will help patients grow new blood vessels rapidly.”

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Small, Implantable Cardiac Pump to Help Children Awaiting Heart Transplant

arfarin, a widely used oral anticoagulant, requires personalized dosing for each patient following heart surgery, unlike other drugs which have a standard adult dosage. The dosage determination depends on the International Normalized Ratio (INR) test, a blood test that gauges the blood's clotting time. Achieving the appropriate warfarin dosage is critical; too low a dose could lead to clot formation, whereas too high a dose increases the risk of internal bleeding or other serious complications. Frequent INR monitoring is essential post-initiation of warfarin therapy to assess the patient's drug response. The warfarin dose is then adjusted based on achieving a therapeutic INR range. This dosage adjustment process continues until the desired INR range is attained. However, finding the correct warfarin dose can be challenging due to the multitude of factors influencing its effectiveness, including genetic makeup, kidney and liver function, and the timing of drug initiation post-surgery. Until now, clinicians had to manually consider all these variables for determining the patient's dose. But now, a new artificial intelligence (AI) tool can automatically account for them and calculate a dose for use as a reference.

The AI tool developed by a group of researchers at St. Michael’s Hospital (Toronto, Canada; www.unityhealth.to) can help clinicians prescribe warfarin to heart surgery patients by guiding their use of the blood thinner medication. The tool was developed using data from more than 1,000 heart surgery patients who were administered warfarin that included variables such as patient characteristics, health conditions, individual warfarin doses, and response to the anticoagulant. The tool was then tested using a second set of data and validated for accuracy. The tool incorporates two validated AI models: one for predicting the warfarin dose in patients undergoing mechanical valve replacement, and another for dosing in all other heart surgery patients. This AI tool is currently in use at St. Michael’s Hospital, where it has received positive

feedback from clinicians.

“People talk about the art of dosing, and some clinicians have a knack for it. But the nice thing about this tool is that it’s an extra layer of validation for patients for whom we’re struggling to get the right dose,” said Lindsay Dryden, St. Michael’s Hospital clinical pharmacist. “It’s something that clinicians can hang their hat on and that gives them a bit more confidence.”

“It’s a predictive tool that’s based off retrospective data – so if a patient comes in with similar characteristics and variables of past patients, we can predict how they might respond to a similar warfarin dose,” added Jacquelin Song, interim manager of Practice Innovation and Change. “This is an extra tool to help support clinical decision-making, almost like a second opinion.”

World’s Smallest Implantable Brain Stimulator Demonstrated in Human Patient

mplantable devices that deliver electrical stimulation to the central or peripheral nervous system are increasingly employed in the treatment of psychiatric conditions, movement disorders, and pain issues, and for helping to restore mobility after spinal cord injuries. However, the current implantable devices used for brain stimulation depend on comparatively large batteries. These batteries need to be implanted under the skin at a location different from the stimulation device and are connected by long wires. This arrangement requires additional surgeries, increases the risk of hardware complications like wire breakage, and often requires surgeries to replace batteries. Engineers have now developed what is considered the smallest implantable brain stimulator used in a human to date. Utilizing innovative magnetoelectric power transfer technology, this tiny device

can be wirelessly powered by an external transmitter and is capable of stimulating the brain through the dura—the protective membrane that lines the base of the skull.

This device, created by engineers at Rice University (Houston, TX, USA; rice.edu) and dubbed the Digitally programmable Over-brain Therapeutic (DOT), could transform the treatment landscape for drug-resistant depression and other psychiatric or neurological disorders. It provides a less invasive alternative compared to existing neurostimulation therapies and other brain-computer interfaces (BCIs), offering greater patient autonomy and easier access. The device utilizes a material that efficiently converts magnetic fields into electrical energy. This conversion is highly efficient even at small dimensions and tolerates alignment errors well, simplifying the activation and control processes. The device itself is 9 millimeters wide and capable of delivering up to 14.5 volts of electrical stimulation.

In initial tests, the device was temporarily implanted in a human patient to stimulate the motor cortex, the brain region that controls movement, successfully eliciting a hand movement. Further tests showed that the device could stably interface with the brain for up to 30 days in pig models. The implant procedure, taking about 30 minutes, involves placing the device within the skull bone, resulting in an almost invisible incision and implant site. Patients would be able to return home on the same day as the procedure. The technology could allow it to be operated comfortably from home. Doctors would prescribe and oversee the treatment, but patients would manage the application themselves.

“In the future, we can place the implant above other parts of the brain, like the prefrontal cortex, where we expect to improve executive functioning in people with depression or other disorders,” said Jacob Robinson, a professor of electrical and computer engineering and of bioengineering at Rice.

Image: AI can help decide the right dose for prescribing warfarin to heart surgery patients (Photo courtesy of Tatiana Shepeleva/Shutterstock)

Google Cloud in Radiology AI Alliance with Bayer

Bayer (Leverkusen, Germany; www.radio logysolutions.bayer.com) and Google Cloud (Mountain View, CA, USA; https://cloud. google.com) have entered into a collaboration to develop AI solutions that can support radiologists. As part of the collaboration, Bayer will further develop its innovation platform to speed up the development and deployment of AI-powered healthcare applications with a clear focus on radiology, using Google Cloud's technology, including its generative AI (gen AI) tools. The collaboration aims to help overcome several challenges faced by organizations in building scalable and compliant AI-powered medical imaging software products using leading data security capabilities and speed up the development of potentially groundbreaking and impactful solutions that can benefit patients.

search and data preparation capabilities. Additionally, users can explore and extract information from regulations and scientific papers, all within a collaboration platform with the latest data security capabilities. Developers can also scale and engineer solutions using gen AI assistance for ideation, development, validation, and lifecycle management; generate documents in alignment with healthcare requirements to aid in gaining regulatory approval; leverage medical imaging core lab services from Bayer for clinical performance evaluation.

Bayer's innovation platform provides a cloud-native pipeline from product idea to launch. Users can uncover insights with AI-powered data analysis, and help design breakthrough healthcare solutions by accessing a data ecosystem, as well as using intelligent

SHealthcare and life science companies can deploy gen AI medical solutions standardized for flexible integration across compatible healthcare systems; and analyze field data for insights, bias detection, and continuous improvement. The platform is built on Google Cloud and uses tools like Vertex AI, BigQuery, Healthcare API, and Chronicle. Bayer's platform is designed to help bring innovative medical imaging tools to market faster and more cost-effectively. The company plans to make the first version for extended testing available later this year in the EU and US.

Samsung and Bracco in Ultrasound Technology Collaboration

amsung Medison (Seoul, South Korea; www. samsungmedison.com) and Bracco Imaging (Milan, Italy; www.bracco.com) have entered into a Memorandum of Understanding to pioneer a new area for diagnostic ultrasound devices and contrast agents. Both companies are considering collaborative research to develop protocols for high-frequency and super-resolution imaging for diagnostic purposes. Samsung Medison is among the world's leading manufacturers of

Radcal to be Acquired by Belgian Technology Concern

Ion Beam Applications S.A. (IBA, Louvain-La-Neuve, Belgium; www.iba-worldwide.com), a leader in particle accelerator technology and dosimetry and quality assurance (QA) solutions, has entered into an agreement to acquire all the assets of Radcal Corporation (Monrovia, CA, USA; www.radcal.com), a leader in diagnostic X-ray measurement. With the acquisition of Radcal, IBA will further strengthen its Medical Imaging Quality Assurance offerings as well as its presence in the US market.

Radcal introduced its first X-ray dosemeter, with the capability to interchange sensors without any loss in accuracy, almost 50 years ago. The integration of Radcal into IBA’s business is expected to aid in its continued growth in the dosimetry and quality assurance fields as well as expanding its product offerings across OEM and clinical segments in the US and around the world.

Hologic Buys UK-Based Breast Surgical Guidance Developer

Hologic, Inc. (Marlborough, MA, USA; www.hologic.com) is to acquire Endomagnetics Ltd. (Cambridge, UK; www. endomag.com), a privately held developer of breast cancer surgery technologies, for approximately USD 310 million, subject to working capital and other customary closing adjustments.

Endomag develops and sells breast surgery localization and lymphatic tracing technologies. Its products include the Magseed marker for magnetic tissue localization before surgery and the Magtrace lymphatic tracing injectable for breast cancer staging. At the heart of Endomag’s product platform is the Sentimag localization system, a non-radioactive surgical guidance platform that offers both tissue localization and breast cancer staging in one platform. The Sentimag uses a probe that works like a metal detector and is used to detect Endomag’s magnetic seed (Magseed) and liquid tracer (Magtrace) for removing tumors and performing minimally invasive staging procedures.

ultrasound diagnostic devices while Bracco Imaging is a global leader in precision diagnostic imaging modalities. The two companies are considering collaborative research to develop protocols for high-frequency and super-resolution imaging for diagnostic purposes. This agreement will also focus on global marketing activities including educating healthcare providers, jointly participating in strategic events, and exploring the possibilities in ultrasound-targeted contrast-enhanced drug delivery technologies in association with pharmaceutical agents.

For a free listing of your event, or a paid advertisement in this section, contact: International Calendar, HospiMedica International E-mail: info@globetech.net

2024

JUNE

12th Congress of the World Federation of Pediatric Intensive and Critical Care Societies. Jun 1-5; Cancun, Mexico; wfpiccs.org

India Health 2024. Jun 13-15; New Delhi, India; indiahealth-exhibition.com

EHA 2024 - Annual Congress of the European Hematology Association. Jun 13-16; Madrid, Spain; ehaweb.org

MedtecLIVE 2024. Jun 18-20; Stuttgart, Germany; medteclive.com

CARS 2024 – Computer Assisted Radiology and Surgery. Jun 18-21; Barcelona, Spain; cars-int.org

FIME 2024 – Florida International Medical Expo. Jun 19-21; Miami, FL, USA; fimeshow.com

ICEM 2024 – 22nd International Conference on Emergency Medicine. Jun 19-23; Taipei. Taiwan; ifem.cc

Medical Taiwan 2024. Jun 20-22; Taipei, Taiwan; medicaltaiwan.com.tw

ESICM EuroAsia 2024 – European Society of Intensive Care Medicine (ESICM) & Indian Society of Critical Care Medicine (ISCCM). Jun 20-23; Bengaluru, India; esicm.org

SIIM 2024 – Annual Meeting of the Society for Imaging Informatics in Medicine. Jun 27-29; National Harbor, MD, USA; siim.org

JULY

ESHRE 2024 – 40th Annual Meeting of the European Society of Human Reproduction and Embryology. Jul 7-10; Amsterdam, Netherlands; eshre.eu

Meditech 2024 – 8th International Health Fair. Jul 9-12; Bogota, Colombia; feriameditech.com

Asia Health 2024. Jul 10-12; Bangkok, Thailand; medlabasia.com

SCCT 2024 – 19th Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography. Jul 18-21; Washington, DC, USA;

scct.org

IndoHealthCare 2024. Jul 31 - Aug 2; Jakarta, Indonesia; indohealthcareexpo.com

AUGUST

38th Medicall Expo. Aug 2-4; Chennai, India; medicall.in

APICS 2024 – Asia Pacific Intensive Care Symposium. Aug 17-19; Singapore; sg-apics.com Expo Med – Hospitalar Mexico 2024. Aug 2022; Mexico City, Mexico; expomed.com.mx

Medical Fair China 2024. Aug 21-23; Shanghai, China; medicalfair.cn

International Surgical Week 2024 – 50th World Congress of the International Society of Surgery ISS/SIC. Aug 25-29; Kuala Lumpur, Malaysia; isw2024.org

ESC Congress 2024 - European Society of Cardiology. Aug 30 - Sep 2; London, UK: escardio.org

SEPTEMBER

Medic East Africa 2024. Sep 4-6; Nairobi, Kenya; mediceastafrica.com

ESRA 2024 – 41st Annual Congress of the European Society of Regional Anaesthesia and Pain Therapy. Sep 4-7; Prague, Czech Republic; esracongress.com

UAA 2024 – 21st Urological Association of Asia Congress. Sep 5-8; Bali, Indonesia; uaanet.org

ERS International Congress 2024 – European Respiratory Society. Sep 7-11; Vienna, Austria; erscongress.org

EASD 2024 – 60th Annual Meeting of the European Association for the Study of Diabetes. Sep 9-13; Madrid, Spain; easd.org

47th World Hospital Congress of the International Hospital Federation (IHF). Sep 10-12; Rio de Janeiro, Brazil; ihf-fih.org

Medical Fair Asia 2024. Sep 11-13; Singapore; medicalfair-asia.com

ASCI 2024 – The 17th Congress of Asian Society of Cardiovascular Imaging. Sep 12-14;

Shanghai, China; asci-heart.org

ESMO Congress 2024 - European Society for Medical Oncology. Sep 13-17; Barcelona, Spain; esmo.org

CIRSE 2024 – Annual Congress of the Cardiovascular and Interventional Radiological Society of Europe. Sep 14-18; Lisbon, Portugal; cirse.org

ISUOG World Congress 2024 – 34th World Congress on Ultrasound in Obstetrics and Gynecology. Sep 15-18; Budapest, Hungary; isuog.org

ISS 2024 Annual Meeting – International Skeletal Society. Sep 15-20; Montreal, QC, Canada; internationalskeletalsociety.com

ExpoMedical 2024. Sep 18-20; Buenos Aires, Argentina; expomedical.com.ar

20th EuGMS Congress – European Geriatric Medicine Society. Sep 18-20; Valenica, Spain; eugms2024.com

CBR24 – 53rd Congress of the Brazilian College of Radiology and Diagnostic Imaging. Sep 1921 Salvador, Brazil; cbr.org.br

38th ESVS Annual Meeting 2024 – European Society of Vascular Surgery. Sep 24-27; Krakow, Poland; esvs.org

REHACARE 2024 – International Trade Fair for Rehabilitation and Care. Sep 25-28; Dusseldorf, Germany; rehacare.com

CADI 2024 – Argentinian Congress of Diagnostic Imaging. Sep 26-28; Buenos Aires, Argentina; sar.org.ar

ASTRO 2024 – 66th Annual Scientific Meeting of the American Society for Radiation Oncology. Sep 29 – Oct 2; Washington, DC, USA; astro.org

ACEP24 – Scientific Assembly of the American College of Emergency Physicians. Sep 29 - Oct 2; Las Vegas, NV, USA; acep.org

OCTOBER

HIMSS24 APAC Health Conference & Exhibition - Healthcare Information and Management Systems Society. Oct 1-4; Seoul, Korea; himssapackorea.kr

ESSO 43 – 43rd Congress of the European Society of Surgical Oncology. Oct 2-4; Antwerp, Belgium; esso43.org

KCR 2024 – 80th Korean Congress of Radiology. Oct 2-5; Seoul, Korea; kcr4u.org

EUSOBI 2024 - Annual Scientific Meeting of the European Society of Breast Imaging. Oct 3-5; Lisbon, Portugal; eusobi.org

JFR 2024 - Journées Francophones de Radiologie. Oct 4-7; Paris, France; jfr.plus 39th Medicall Expo. Oct 5-7; New Delhi, India; medicall.in

ECISM LIVES 2024 – Annual Congress of European Society of Intensive Care Medicine. Oct 5-9; Barcelona, Spain; esicm.org

MICCAI 2024 – 27th International Conference on Medical Image Computing and Computer Assisted Intervention. Oct 6-10; Marrakesh, Morocco; miccai.org

Medical Japan 2024 Tokyo– International Medical and Elderly Care Expo. Oct 9-11; Tokyo, Japan; medical-jpn.jp

UEG Week 2024 – United European Gastroenterology. Oct 12-15; Vienna, Austria; ueg.eu

CMEF Autumn 2024 – 90th China Medical Equipment Fair. Oct 12-15; Shenzhen, China; cmef.com.cn

EUSEM 2024 – 18th European Emergency Medicine Congress. Oct 13-16; Copenhagen, Denmark; eusemcongress.org

RANZCR 2024 – 74th Annual Scientific Meeting of The Royal Australian and New Zealand College of Radiologists. Oct 17-19; Perth, Australia; ranzcrasm.com

ANESTHESIOLOGY 2024 – Annual Meeting of the American Society of Anesthesiologists. Oct 18-22; Philadelphia, PA, USA; asahq.org

ACS Clinical Congress 2024 – American College of Surgeons. Oct 19-22; San Francisco, CA, USA; facs.org

EANM 2024 – 37th Annual Congress of the European Association of Nuclear Medicine. Oct 19-23; Hamburg, Germany; eanm.org

Global Health Exhibition 2024. Oct 22-24; Riyadh, Saudi Arabia; globalhealthsaudi.com

Africa Health 2024. Oct 22-24; Johannesburg, South Africa; africahealthexhibition.com 16th World Stroke Congress - World Stroke Organization. Oct 23-26; Abu Dhabi, UAE; worldstrokecongress.org

ESCR Annual Scientific Meeting 2024 – European Society of Cardiovascular Radiology. Oct 24-26; Dubrovnik, Croatia; escr.org

NOVEMBER

ASUM 2024 – Conference of the Australasian Society for Ultrasound in Medicine. Nov 1-3; Brisbane, Australia; asum.com.au

BSIR 2024 – Annual Scientific Meeting of the British Society of Interventional Radiology. Nov 6-8; Brighton, UK; bsirmeeting.org

APSR 2024 – 28th Congress of the Asian Pacific Society of Respirology. Nov 7-10; Singapore; apsr2024.hk

51st COMMEC Congress 2024 – Mexican Congress of Critical Medicine. Nov 8-13; Acapulco, Mexico; congresocommec2024.mx

MEDICA 2024. Nov 11-14; Dusseldorf, Germany; medica-tradefair.com

CBMI 2024 – 29th Brazilian Congress of Intensive Care Medicine. Nov 14-16; Sao Paulo, Brazil; amib.org.br

ASUS 2024 – 7th Congress of Asian Surgical Ultrasound Society. Nov 16-17; Seoul, Korea, asus2024.org

62nd Annual ESPE Meeting 2024 – European Society for Paediatric Endocrinology. Nov 1618; Liverpool, UK; eurospe.org

DECEMBER

RSNA 2024 – Annual Meeting of the Radiological Society of North America. Dec 1-5; Chicago, IL, USA; rsna.org

66th ASH Annual Meeting and Exposition –American Society of Hematology. Dec 7-10; San Diego, CA, USA; hematology.org

JANUARY

AOCR 2025 – Asian Oceanian Congress of Radiology. Jan 23-26; Chennai, India; aocr2025.org

Arab Health 2025. Jan 27-30; Dubai, UAE; arabhealthonline.com

FEBRUARY

WCN 2025 – World Congress of the International Society of Nephrology (ISN). Feb 6-9; New Delhi, India; theisn.org

SAR 2025 – Annual Meeting of the Society of Abdominal Radiology. Feb 16-21; Tucson, AZ, USA; abdominalradiology.org

Critical Care Congress 2025 – 54th Annual Meeting of the Society of Critical Care Medicine (SCCM). Feb 23-25; Orlando, FL, USA; sccm.org

ESGO 2025 – 26th European Congress on Gynaecological Oncology. Feb 20-23; Rome, Italy; congress.esgo.org

ECR 2025 – European Congress of Radiology. Feb 26 – Mar 2; Vienna, Austria; myesr.org

MARCH

HIMSS25 - Healthcare Information and Management Systems Society. Mar 3-6; Las Vegas, NV, USA; himss.org

Medical Japan 2025 Osaka – International Medical and Elderly Care Expo. Mar 5-7; Osaka, Japan; medical-jpn.jp

AAOS 2025 Annual Meeting – American Academy of Orthopaedic Surgeons. Mar 10-14; San Diego, CA, USA; aaos.org

EMIM 2025 – 20th Meeting of the European Society for Molecular Imaging. Mar 11-14; Bilbao, Spain; e-smi.eu

SAGES 2025 – Annual Meeting of the Society of American Gastrointestinal and Endoscopic Surgeons. Mar 12-15; Long Beach, CA, USA; sages.org

52nd Annual Meeting of the Japanese Society of Intensive Care Medicine (JSICM). Mar 1416; Fukuoka, Japan; jsicm.org

44th ISICEM – International Symposium on Intensive Care & Emergency Medicine. Mar 18-21; Brussels, Belgium; isicem.org

Medical Fair India 2025. Mar 20-22; New Delhi, India; medicalfair-india.com

KIMES 2025 – Korea International Medical & Hospital Equipment Show. Mar 20-23; Seoul, Korea; kimes.kr

40th Annual EAU Congress – European Association of Urology. Mar 21-24; Madrid, Spain; uroweb.org

DCK 2025 – 142nd Congress of the German Society for Surgery (DGCH). Mar 26-28; Munich; Germany; dgch.de

SIR 2025 – Annual Meeting of the Society of Interventional Radiology. Mar 29 - Apr 1; Nashville, TN, USA; sirmeeting.org

APRIL

AAEM25 – 31st Annual Scientific Assembly of the American Academy of Emergency Medicine. Apr 6-10; Miami, FL, USA; aaem.org

CMEF Spring 2025 – 91st China Medical Equipment Fair. Apr 8-11; Shanghai, China; cmef.com.cn

15th FEPIMCTI Congress 2025 – Pan American and Iberian Federation of Critical Medicine and Intensive Therapy. Apr 8-12; Panama City, Panama; fepimcti.org

125th Congress of the Japan Surgical Society (JSS). Apr 10-12; Sendai, Japan; jp.jssoc.or.jp

WCO-IOF-ESCEO 2025 - World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases. Apr 10-13; Rome, Italy; wco-iof-esceo.org

84th Annual Meeting of Japan Radiological Society (JRS). Apr 10-13; Yokohama, Japan; radiology.jp

Medic West Africa 2025. Apr 16-18; Lagos, Nigeria; medicwestafrica.com

APSC-KCS 2025 - 29th Asian Pacific Society of Cardiology Congress & Korean Society of Cardiology Congress. Apr 17-19; Busan, Korea; apscardio.org

145th Annual Meeting of the American Surgical Association (ASA). Apr 24-26; San Diego, CA, USA; americansurgical.org

Expomed Euroasia 2025. Apr 24-26; Istanbul, Turkey; expomedistanbul.com

ARRS 2025 Annual Meeting – American Roentgen Ray Society. Apr 27 - May 1; San Diego, CA, USA; arrs.org

MAY

93rd EAS Congress 2025 – European Atherosclerosis Society. May 4-7; Glasgow, UK; eas-society.org

ESGAR 2025 – Annual Meeting of the European Society of Gastrointestinal and Abdominal Radiology. May 13-16; Amsterdam, Netherlands; esgar.org

25th MEDEXPO Africa 2025. May 14-16; Nairobi, Kenya; expogr.com/kenyamed 2025 ISMRM & ISMRT Annual Meeting & Exhibition – International Society for Magnetic Resonance in Medicine. May 10-15; Honolulu, HI, USA; ismrm.org

ATS 2025 – International Conference of the American Thoracic Society. May 16-21; San Francisco, CA, USA; conference.thoracic.org Hospitalar 2025. May 20-23; Sao Paulo, Brazil; hospitalar.com

KIHE 2025 – 30th Kazakhstan International Healthcare Exhibition. May 21-23; Almaty, Kazakhstan; kihe.kz

EuroAnaesthesia 2025 – European Society of Anaesthesiology. May 25-27; Lisbon, Portugal; euroanaesthesia.org

WFUMB 2025 – 20th Congress of the World Federation of Ultrasound in Medicine and Biology. May 29 - Jun 1; Kyoto, Japan; wfumb.info

JUNE

62nd ERA Congress – European Renal Association. Jun 4-7; Vienna, Austria; era-online.org

EFORT Congress 2025 – 26th Annual Congress of European Federation of National Associations of Orthopaedics and Traumatology. Jun 11-13; efort.org

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